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Infection Risks Associated with Spirometry

Published online by Cambridge University Press:  21 June 2016

Donna Renfrow Rutala ,
William A. Rutala ,
David J. Weber  and
Charlotte A. Thomann
Donna Renfrow Rutala
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill, North Carolina
William A. Rutala*
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill, North Carolina Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
David J. Weber
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill, North Carolina Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Charlotte A. Thomann
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill, North Carolina
*
547 Burnett-Womack Building CB #7030, University of North Carolina School of Medicine, UNC at Chapel Hill, Chapel Hill, NC 27599-7030
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Abstract

Objectives:

Spirometry is a widely used pulmonary function test that allows measurement of forced vital capacity and time-related measures of dynamic pulmonary function. This study was designed to identify the risk of cross-transmission associated with two commonly used dry-rolling seal spirometers.

Design:

Using a prospective study design, we examined whether microbial contamination of spirometers occurred following use by patients with a heavily colonized or infected respiratory tract. Prior to spirometry evaluation, a patients sputum culture and equipment samples (i.e., mouthpiece, proximal tubing, piston surface) were obtained. After patient evaluation, a sterile 2 L ventilation bag and sterile tubing were used to simulate the risk of infection of subsequent patients. Simulation 1 was performed immediately after patient testing and Simulation 2, representing a second patient was conducted approximately 18 hours later.

Setting:

This study was conducted at the University of North Carolina Hospitals, a large university teaching facility.

Patients:

Fourteen patients with underlying pulmonary disease were studied.

Results:

Our study revealed that the mouthpieces became contaminated with the patients' oral flora and with the associated respiratory pathogen. Fourteen percent of the associated tubing after patient testing contained the respiratory pathogen. All other equipment samples (e.g., interior surfaces of the machine, Simulation 1, Simulation 2 samples) were negative for the respiratory pathogen.

Conclusions:

These data suggest that mouthpieces and spirometry tubing may become contaminated with microorganisms and should not be shared between patients. Since there is little or no bacterial contamination of the surfaces inside the spirometers and cross transmission is unlikely, it is unnecessary to routinely clean the interior surfaces of the spirometers. (Infect Control Hosp Epidemiol. 1991;12:89-92.)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 2 , February 1991 , pp. 89 - 92
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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References

1. Gardner, RM, Crapo, RO. Nelson, SB. Spirometry and flow-volume curves. Clin Chest Med. 1989;10:145–154.Google Scholar
2. Mahler, DA, Loke, J. The pulmonary function laboratory. Clin Chest Med. 1989;10:129–134.Google Scholar
3. American Thoracic Society. Standardization of spirometry-1987 update. Am Rev Respir Dis. 1987;136:1285–1298.Google Scholar
4. Ali, BA, Abro, YM, Javed, NH, Islam, MS. Standardization of different spirometers. Respiration. 1988;53:58–63.Google Scholar
5. Glindmeyer, HW, Jones, RN, Barkman, HW, Weill, H. Spirometry: quantitative test criteria and test acceptability. Am Rev Respir Dis. 1987; 136:449–452.10.1164/ajrccm/136.2.449Google Scholar
6. Ayliffe, GAJ. Equipment-related infection risks. J Hosp Infect. 1988;IIA:279–284.CrossRefGoogle Scholar
7. Craven, DE, Steger, KA. Nosocomial pneumonia in the intubated patient. In: Weber, DJ, Rutala, WA, eds. Nosocomial Infections. New Issues and Strategies, for Prevention. Infectious Disease Clinics of North America. 4th vol. Philadelphia, Penn: W.B. Saunders; 1989:843–866.Google Scholar
8. Rutala, WA, Weber, DJ. Environmental issues and nosocomial infections. In: Farber, BE ed. Infection Control in Intensive Care. New York, NY: Churchill Livingstone; 1987:131–172.Google Scholar
9. Carroll, AR, Goularte, TA, McGinley, KN, Craven, DE. An outbreak of Pseudomonas maltophilia in intensive care units traced to contaminated respiratory therapy equipment. Presented at 12th Annual Association for Practitioners in Infection Control Educational Conference, May 12-17,1985. Cincinnati, Ohio.Google Scholar
10. Irwin, FS, Demers, RR, Pratter, MR, Garrity, FL, Miner, G, Pritchard, A, Whitaker, S. An outbreak of Acinetobacter infection associated with the use of a ventilator spirometer. Respir Care. 1980;25:232–237.Google ScholarPubMed
11. Tablan, CC, Williams, WW, Martone, WJ. Infection control in pulmonary function laboratories. Infect Control. 1985;6:442–444.CrossRefGoogle ScholarPubMed
12. Hazaleus, RE, Cole, J, Berdischewsky, M. Tuberculin skin test conversion from exposure to contaminated pulmonary function testing apparatus. Respir Care. 1981;26:53–55.Google Scholar
13. Lennette, EH, Balows, A, Hausier, WJ, et al. Manual of Clinical Microbiology. 2nd ed. Washington, DC: American Society for Microbiology; 1985.Google Scholar
14. Cross, AS, Roup, B. Role of respiratory assistance devices in endemic nosocomial pneumonia. Am J Med. 1981;70:681–685.10.1016/0002-9343(81)90596-9Google Scholar
15. Duncalf, D. Care of anesthetic equipment and other devices. Arch Surg. 1973;107:600–602.10.1001/archsurg.1973.01350220078016Google Scholar
16. Simmons, BP, Wong, ES. Guideline for prevention of nosocomial pneumonia. Infect Control. 1982;3:327–333.Google Scholar
17. Perea, EJ, Criado, A, Moreno, M, Avello, F. Mechanical ventilators as vehicles of infection. Acta Anaesthesiol Scand. 1975:19:180–186.CrossRefGoogle ScholarPubMed
18. Reinarz, JA Pierce, AK, Mays, BB, Sanford, JE The potential role of inhalation therapy equipment in nosocomial pulmonary infection. J Clin Invest. 1965;44:831–839.CrossRefGoogle ScholarPubMed
19. Depledge, MH, Barrett, A. Aseptic techniques for lung function testing. J Hosp Infect. 1981;2:369–372.Google Scholar
20. Gold, PM, Schwesinger, DW. Pulmonary laboratory infection control and safety. In: Clausen, JL, Zarins, LP, eds. Pulmonary Function Testing Guidelines and Controversies. New York, NY: Academic Press; 1982:15–22.Google Scholar